Capital Credits Beneficiary or Personal Representative’s Refund Request Form

This form is for beneficiaries who are claiming capital credits that were allocated to a SMECO member who is now deceased.

If you are a SMECO member and you wish to designate a beneficiary for your capital credits, fill out the Beneficiary Designation Form.

Deceased SMECO Member's Information

Deceased Member's Name(Required)

First Last

Last 4 Digits of Member's Social Security Number(Required)

Last Known SMECO Service Address(Required)

Street Address Address Line 2 City State ZIP Code

Beneficiary

Your Name(Required)

First Last

Your Phone Number(Required)

Your Date of Birth (mm/dd/yyyy)(Required)

Last 4 Digits of Your Social Security Number(Required)

Your Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Email Address(Required)

Your Relationship to Deceased Member(Required)

Refund options for beneficiary or personal representative(Required)

Final lump-sum refund payable to the customer's estate at present value.

Continue general refunds when approved by SMECO's Board of Directors. Note: general refunds are a percentage of the customer's capital credit balance, may take several years to pay in full, are subject to minimum check requirements, and will be payable to the customer's estate.

Additional Information (if any)

Copy of Death Certificate(Required)

Max. file size: 400 MB.

Copy of Your Government-Issued Photo ID(Required)

Max. file size: 400 MB.

Copy of Court-Issued Letter of Administration/Appointment of Personal Representative

Max. file size: 400 MB.

Electronic Signature (type your name)(Required)